patient
guide

Why Pain Management?

The goal of pain management is to keep your pain at a reasonable level, allowing you to recover from surgery and get back to normal activities. Pain is more than just what you feel. Severe pain causes distress, slows healing, increases the risk of blood clots and pneumonia, and can turn into long-term chronic pain.

Unfortunately, some degree of pain is involved with having surgery. To complicate things, everyone experiences pain differently, meaning a well managed post-operative pain management plan is necessary.

How is Post-Operative Pain Treated?

Post-operative pain is different than pain you experience in everyday life. Surgery causes changes to your nervous system that make you feel pain more severely (called hyperalgesia). There are several causes of post-operative pain including tissue (like skin or muscle) damage, nerve damage, inflammation, and muscle spasms.

This is why it’s important to treat post-operative pain with a variety of medications. These not only block pain (analgesia), but treat its various causes while protecting you from hyperalgesia. The following types of medications may be used:

• Anti-inflammatory medications (NSAIDs or steroids)
• Medications that protect your nervous system (gabapentinoids and anti-depressants)
• Medications that block pain (acetaminophen or numbing drugs like lidocaine)
• Muscle relaxants

What are Opioids?

Opioids have a very powerful ability to block pain, but we’ve learned that they need to be reserved as a last resort for treatment. Opioids are one of the most dangerous medications for people to take because they not only cause sedation, but they depress your bodies drive to breathe. Opioids also cause both a rapid build-up of hyperalgesia and tolerance to the drug in the body. If you take an oral opioid every 4-6 hours, it only takes 3 days before your body will be totally tolerant to that medication and you will need to take a larger dose for pain control. On top of that, there are several very unpleasant side effects that opioids can cause, including:

• Nausea
• Itching
• Constipation
• Tiredness but not able to enter a deep, restful sleep state

The most talked about and serious issue with using opioid pain medications is the potential for addiction. Taking an opioid for more than 5 days dramatically increases your risk of addiction.

What should I discuss with my provider?

It is important to discuss your pain management program with both your surgeon and anesthesia provider. Beyond using the knowledge you’ve gained above, we’ve compiled some additional items to discuss.

Pain Management Strategies

Some important strategies for managing your post-operative pain are:

• treating pain before it is severe
• taking non-opioid medications on a schedule
• only using the opioids as needed when the pain becomes severe
• and taking several types of medications to manage the different causes of post-operative pain

Nerve Blocks

Another great discussion you should have with your surgeon and anesthesia provider is on the use of peripheral nerve blocks or spinal and epidural pain control after surgery. These are injections of numbing medicine that can be given through single injection or continual infusion via catheter (the anesthesia kind, not the urological kind). They greatly reduce and/or eliminate your pain while they’re in effect. Receiving this type of pain control is extremely beneficial, but also carries its own risks and side effects.  Keep in mind, unfortunately not all providers are trained in these types of administration techniques.